PUNISHING THE POOR

Activists have been trying for years to bring down the pharmaceutical industry. Their “patients not patents” campaign has a simplistic appeal but will only make things worse for the poor, as well as distracting attention from the real causes of ill health: poverty and corruption.

The patents that protect today’s innovations and drive research and development to create tomorrow’s life-saving treatments are under threat at a forthcoming World Health Organisation meeting. Ahmed Ogwell, of Kenya’s Ministry of Health, a big player in the meeting, claims that drug production, backed by intellectual property protection, “has failed quite dramatically in Africa (...) that is why the disease burden is in fact probably increasing in some areas.”

For poor Africans, intellectual property is not the issue and Kenya’s Ministry of Health should know better. Less than 2% of the WHO’s list of essential medicines is protected by patents. In 2005, the head of the WHO's AIDS division, Kevin de Cock, said: "It is very obvious (...) that the elephant in the room is not the current price of drugs. The real obstacle is the fragility of the health systems. You have health infrastructure that is dilapidated, a health workforce that is demoralized, labs that don't work, supply chains that don't exist and diagnostics that are missing."

Without these things, you can give drugs away for free and they still won’t get to the most needy.

But this doesn’t appear to matter to activist organisations like Doctors Without Borders and Oxfam. Along with the WHO, they want African countries to repeat the steps taken by their current favourite, Thailand. There, the former military government issued “compulsory licences” that breach patents on some AIDS medicines, claiming that prices made it impossible to supply all Thai patients.

Screaming headlines diverted attention from what matters most in Thailand, as in sub-Saharan Africa: hospital closures, staff shortages and corruption. Without hospitals and doctors, cheaper drugs are not much use--and doling out sub-standard medicines can do more harm than good, as Thailand’s AIDS drug GPO-Vir has demonstrated.

In sub-Saharan Africa, access to medicines remains a terribly low 50% but cost is not the problem. In spite of almost US$600 million in development aid to Malawi in 2005 alone, there are just two doctors for every 100,000 people there. The Global Fund is considering suspending two of Nigeria's five-year grants totalling US$80 million because of mis-management. Recent surveys in Nigeria show that 28 public health centres had received no drugs from the federal government for two years. Grants to Uganda and Chad have been cancelled for similar reasons.

Undermining patents is the road India trod many years ago. In 1972, a very poor India weakened its IP laws in the hope of cutting medicine prices. Some drugs were certainly made cheaper but it was no panacea: at least 60% of Indians still do not have access to cheap, off-patent, medicines. Children go without routine vaccinations. Simple generic (unpatented and cheap) anti-infectives are out of reach of the majority of the rural poor. Despite pumping out cheap generic AIDS drugs for years, only 5% of India’s AIDS sufferers were receiving any drugs by the end of 2006.

Proper IP laws were passed in 2005 and started making the country safe for local and foreign investment, for innovation and for hi-tech production. In spite of the activists’ dire forecasts, prices of medicines have not shot up.

A new democratically-elected Thai government is already trying to reverse the junta’s patent-busting because of the damage done to investment into the country.

But Kenya and its activist advisors want to take Africa down that road. Unaccountable, mainly Western, organisations with narrow agendas have the ear of governments at the end of April during the Intergovernmental Working Group on Health, Innovation and Intellectual Property(IGWG). Its recommendations will undermine intellectual property rights unless Member States take a stand now.

The attack on patents is not a defence of patients or the poor. It is diverting attention from what really matters: infrastructure, doctors and nurses. Prosperity is the key to those services and intellectual property is one of the keys to prosperity: Africans must not let their health and growth be damaged by populist propaganda.

Authors: Franklin Cudjoe is director of Imani, an independent policy think-tank in Ghana. Alec van Gelder is Network Director at International Policy Network, a development think-tank in London.

HPU Feature Article / 11 April 2008